Association between periodontal disease and its treatment, flow-mediated dilatation and carotid intima-media thickness: a systematic review and meta-analysis

Atherosclerosis. 2014 Sep;236(1):39-46. doi: 10.1016/j.atherosclerosis.2014.06.002. Epub 2014 Jun 17.

Abstract

Objective: This meta-analysis sought to investigate the association between carotid intima-media thickness (c-IMT), flow-mediated dilation (FMD) and periodontitis (PD) and to assess the effect of periodontal treatment on c-IMT and FMD.

Methods: Electronic database searching, hand searching of bibliographic references of included papers, related reviews, and journals in relation to oral, cardiovascular and ultrasound imaging field was carried out. Random effects meta-analyses were performed to investigate the association of co-existence of increased c-IMT, impaired FMD and PD with potential changes in these variables following periodontal intervention.

Results: 2009 citations and 101 full text articles were screened, with 35 meeting the review inclusion criteria of which 22 suitable for quantitative analysis. Meta-analysis demonstrated that the diagnosis of PD was associated with a mean increase in c-IMT of 0.08 mm (95% C.I. = 0.07-0.09) and a mean difference in FMD of 5.1% compared to controls (95% C.I. = 2.08-8.11%). A meta-analysis of the effects of periodontal treatment on FMD showed a mean improvement of 6.64% between test and control (95% C.I. = 2.83-10.44%).

Conclusions: This review demonstrated an association between increased c-IMT, impaired FMD and PD. Data from intervention studies suggested a beneficial effect of periodontal treatment on FMD indicating an improvement in endothelial function. The findings support investigation of periodontitis treatment on cardiovascular outcomes.

Keywords: Cardiovascular disease; Carotid intima-media thickness; Endothelial function; Flow-mediated dilatation; Periodontitis.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Brachial Artery / physiopathology
  • Carotid Artery Diseases / epidemiology*
  • Carotid Artery Diseases / pathology
  • Carotid Intima-Media Thickness*
  • Case-Control Studies
  • Causality
  • Comorbidity
  • Controlled Clinical Trials as Topic
  • Cross-Sectional Studies
  • Disease Progression
  • Disease Susceptibility
  • Endothelium, Vascular / physiopathology*
  • Hemorheology
  • Humans
  • Periodontal Diseases / epidemiology*
  • Periodontal Diseases / physiopathology
  • Periodontal Diseases / therapy
  • Periodontitis / complications
  • Periodontitis / physiopathology
  • Periodontitis / therapy
  • Plaque, Atherosclerotic / epidemiology
  • Plaque, Atherosclerotic / pathology
  • Vasodilation / physiology*